Titanium Cage in Comparison with Nano-Hydroxyapatite Bone Graft Substitutes in Cervical Reconstruction

2021 ◽  
Vol 17 (7) ◽  
pp. 1448-1452
Author(s):  
Tao Zhang ◽  
Ying Guo ◽  
Dapeng Zhang ◽  
Runze Zhao ◽  
Naiwu Hu
Keyword(s):  
Cervical Spine ◽  
Bone Graft ◽  
Cervical Spondylosis ◽  
Titanium Cage ◽  
Cage Condition ◽  
Post Operation ◽  
Bone Graft Substitutes ◽  
Sagittal Parameters ◽  
One Year ◽  
Cervical Reconstruction

Cervical spondylosis is a disease that occurs with age and affects the discs and joints in the cervical spine located in the neck. The hydroxyapatite (HA) bone graft substitutes can used as a potential bone-forming agent, however, the efficacy of using HA is challenging in cervical reconstruction. In this regard, nano-based HA was used in this study to explore its sagittal parameters and clinical potency in relative to titanium (TiO2) cage in patient with cervical spondylosis. 50 patients suffering from cervical spondylosis were divided in two groups and were grafted with either TiO2 cage or nano-HA. The sagittal parameters, including cervical spine lateral radiographs (C0−2Coob and C2−7Coob) were taken pre- and post-operation (3-month, one-year and two-year). The clinical potency was also done based on the JOA scores. Angle analysis indicated that the C0−2Cobb and C2−7Cobb angles were significantly changed after the operation in both TiO2 cage and nano-HA groups, whereas no significant changes was determined in nano-HA relative to TiO2 cage condition. Also, it was shown that JOA scores were significantly higher after the operation than pre-operation, indicating a potential cervical reconstruction after surgery in both groups which slightly were higher for nano-HA groups.

Update on the Cloward procedure: new instruments

1994 ◽  
Vol 81 (5) ◽  
pp. 716-720 ◽  
Author(s):  
José M. Otero Vich
Keyword(s):  
Cervical Spine ◽  
Bone Graft ◽  
Anterior Approach ◽  
Cervical Spondylosis ◽  
Herniated Disc ◽  
Content Type ◽  
Cloward Procedure ◽  
Autologous Grafts ◽  
New Instruments ◽  
Fine Print

✓ A series of 283 patients who suffered from cervical spondylosis, herniated disc, or traumatic pathology of the cervical spine were operated on using an anterior approach. Intersomatic arthrodesis was performed in 350 cases; in every case, a threaded bone graft was screwed into the intervertebral orifice using the technique described by the author. Fusion was achieved within 6 months in 93% of cases with 92 autologous grafts and in 81% of cases with 258 heterologous grafts. In addition to the use of threaded intervertebral holes and threaded bone grafts, the Cloward technique was modified by the introduction of a set of new instruments, which largely replaced the ones previously in use. These included a low-speed motor with different drills and trephines, a trephine guide retractor, and an intersomatic retractor.

scholarly journals The importance of preoperative T1 slope for determining proper postoperative C2–7 Cobb’s angle in patients undergoing cervical reconstruction

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Jinshui Chen ◽  
Juying Wang ◽  
Xuepeng Wei ◽  
Huapeng Guan ◽  
Benhai Wang ◽  
...  
Keyword(s):  
Cervical Spondylosis ◽  
Regression Equation ◽  
Improvement Rate ◽  
Thoracic Inlet ◽  
T1 Slope ◽  
Asymptomatic Volunteers ◽  
Sagittal Parameters ◽  
The Mean ◽  
The Difference ◽  
Cervical Reconstruction

Abstract Background This study aimed to explore the relationship among different cervical sagittal parameters in asymptomatic volunteers and the correlation between surgical efficacy and difference of presumed and actual postoperative C2–7 Cobbs’s angle (C2–7COBB), which was calculated based on preoperative T1 slope (T1S) in patients undergoing cervical reconstruction. Methods In total, 158 inpatients with cervical spondylosis and 274 asymptomatic volunteers were retrospectively reviewed. Cervical sagittal parameters, such as C2–7COBB, T1S, thoracic inlet angle (TIA), and neck tilt (NT), were compared. Then, the correlation among these parameters was analyzed in asymptomatic volunteers, and a regression equation between T1S and C2–7COBB was established and used to analyze the correlation among the Japanese Orthopaedic Association (JOA) score improvement, the sagittal parameters, and the difference between presumed and actual postoperative C2–7COBB in patients after cervical reconstruction. Results The mean T1S, C2–7COBB, and TIA were significantly decreased in patients (P < 0.01). T1S and NT had a strong correlation with TIA (P < 0.01). T1S demonstrated a moderate correlation with C2–7COBB in asymptomatic volunteers (r = 0.569, P < 0.01). A regression equation had been established as C2–7COBB = 0.742 × T1S − 0.866. The mean C2–7COBB and JOA score improved significantly (P < 0.05) postoperatively. Moreover, the JOA improvement rate showed a significant negative correlation with the difference in the presumed and actual postoperative C2–7COBB (r = − 0.696, P < 0.01). Conclusion Our study successfully established a regression equation for calculating postsurgical C2–7COBB based on the correlation between T1S and C2–7COBB in asymptomatic volunteers. The regression equation could be used for guiding surgeons to accomplish an ideal postsurgical C2–7COBB for patients with cervical spondylosis.

scholarly journals Synthetic bone graft versus autograft or allograft for spinal fusion: a systematic review

2016 ◽  
Vol 25 (4) ◽  
pp. 509-516 ◽  
Author(s):  
Zorica Buser ◽  
Darrel S. Brodke ◽  
Jim A. Youssef ◽  
Hans-Joerg Meisel ◽  
Sue Lynn Myhre ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cohort Studies ◽  
Bone Graft ◽  
Spinal Fusion ◽  
Comparative Studies ◽  
Functional Outcomes ◽  
Retrospective Studies ◽  
Synthetic Bone ◽  
Synthetic Bone Graft ◽  
Bone Graft Substitutes

The purpose of this review was to compare the efficacy and safety of synthetic bone graft substitutes versus autograft or allograft for the treatment of lumbar and cervical spinal degenerative diseases. Multiple major medical reference databases were searched for studies that evaluated spinal fusion using synthetic bone graft substitutes (either alone or with an autograft or allograft) compared with autograft and allograft. Randomized controlled trials (RCT) and cohort studies with more than 10 patients were included. Radiographic fusion, patient-reported outcomes, and functional outcomes were the primary outcomes of interest. The search yielded 214 citations with 27 studies that met the inclusion criteria. For the patients with lumbar spinal degenerative disease, data from 19 comparative studies were included: 3 RCTs, 12 prospective, and 4 retrospective studies. Hydroxyapatite (HA), HA+collagen, β-tricalcium phosphate (β-TCP), calcium sulfate, or polymethylmethacrylate (PMMA) were used. Overall, there were no differences between the treatment groups in terms of fusion, functional outcomes, or complications, except in 1 study that found higher rates of HA graft absorption. For the patients with cervical degenerative conditions, data from 8 comparative studies were included: 4 RCTs and 4 cohort studies (1 prospective and 3 retrospective studies). Synthetic grafts included HA, β-TCP/HA, PMMA, and biocompatible osteoconductive polymer (BOP). The PMMA and BOP grafts led to lower fusion rates, and PMMA, HA, and BOP had greater risks of graft fragmentation, settling, and instrumentation problems compared with iliac crest bone graft. The overall quality of evidence evaluating the potential use and superiority of the synthetic biological materials for lumbar and cervical fusion in this systematic review was low or insufficient, largely due to the high potential for bias and small sample sizes. Thus, definitive conclusions or recommendations regarding the use of these synthetic materials should be made cautiously and within the context of the limitations of the evidence.

A Novelty of Synthetic Hydroxyapatite from Cockle Shell and Characterization

2015 ◽  
Vol 1087 ◽  
pp. 429-433 ◽  
Author(s):  
Rusnah Mustaffa ◽  
Mohd Reusmaazran Mohd Yusof ◽  
Yusof Abdullah
Keyword(s):  
Bone Graft ◽  
Bone Repair ◽  
Artificial Bone ◽  
Synthetic Bone ◽  
Potential Source ◽  
Mineral Constituent ◽  
Bone Graft Substitutes ◽  
Synthetic Hydroxyapatite ◽  
Anadara Granosa ◽  
Cockle Shell

In Malaysia recently, it was found that cockle shell (Anadara granosa) is a potential source of biomaterial for bone repair. It is the most abundant sea species cultured in Malaysia. A possible advantage of using cockle shell as a biomaterial is that they may act as an antilog of calcium carbonate. Malaysian Nuclear Agency took this challenge to develop synthetic bone graft from natural cockle shell. To date, the artificial bone graft substitutes developed from hydroxyapatite (Ca10(PO4)6(OH)2) a bio ceramic is similar to the mineral constituent of human bone. The structure and the composition of hydroxyapatite (HA) are similar to the mineral phase of bone and, its bioactivity and biocompatibility makes it a preferred bone graft.

A Review of Bone Graft Substitutes Made From HA-Polymer Composite Scaffolds and Fabrication Potential With Laser-Based Additive Manufacturing Processes

2015 ◽  
Author(s):  
Hera Wu ◽  
Shuting Lei
Keyword(s):  
Additive Manufacturing ◽  
Bone Graft ◽  
Three Dimensional ◽  
Bone Graft Substitute ◽  
Biological Properties ◽  
Porous Scaffolds ◽  
Composite Scaffolds ◽  
Bone Graft Substitutes ◽  
Manufacturing Technologies ◽  
High Level

Hydroxyapatite, a bioactive ceramic, has been combined with biodegradable polymers to create composite three-dimensional interconnected porous scaffolds for bone graft substitutes. The materials and fabrication methods of these composite scaffolds are reviewed. The resulting mechanical and biological properties of scaffolds produced from the combination of certain materials and fabrication methods are analyzed. Requirements for a bone graft substitute and third generation scaffolds with the addition of osteoinductive and osteogenic features to composite scaffolds including biomolecule delivery and cell seeding are also introduced. Finally, the benefits of using additive manufacturing technologies to enable high level of control over the design of interconnected pore structure are discussed.

Advances in Bone Graft Substitutes in Spinal Fusion

2003 ◽  
Author(s):  
Michael Tzermiadianos ◽  
Alexander Hadjipavlou ◽  
John Gaitanis
Keyword(s):  
Bone Graft ◽  
Spinal Fusion ◽  
Bone Graft Substitutes
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